{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:38:29Z","timestamp":1792629509424,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">For patients with hypoplastic left heart syndrome, digoxin has been associated with reduced interstage mortality after the Norwood operation, but the mechanism of this benefit remains unclear. Preservation of right ventricular (RV) echocardiographic indices has been associated with better outcomes in hypoplastic left heart syndrome. Therefore, we sought to determine whether digoxin use is associated with preservation of the RV indices in the interstage period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We conducted a retrospective cohort study of prospectively collected data using the public use data set from the Pediatric Heart Network Single Ventricle Reconstruction trial, conducted in 15 North American centers between 2005 and 2008. We included all patients who survived the interstage period and had echocardiographic data post\u2010Norwood and pre\u2010Glenn operations. We used multivariable linear regression to compare changes in RV parameters, adjusting for relevant covariates. Of 289 patients, 94 received digoxin at discharge post\u2010Norwood. There were no significant differences in baseline clinical characteristics or post\u2010Norwood echocardiographic RV indices (RV end\u2010diastolic volume indexed, RV end\u2010systolic volume indexed, ejection fraction) in the digoxin versus no\u2010digoxin groups. At the end of the interstage period and after adjustment for relevant covariates, patients on digoxin had better preserved RV indices compared with those not on digoxin for the \u0394RV end\u2010diastolic volume (11 versus 15\u00a0mL,\n              <jats:italic>P<\/jats:italic>\n              =0.026) and the \u0394RV end\u2010systolic volume (6 versus 9\u00a0mL,\n              <jats:italic>P<\/jats:italic>\n              =0.009) with the indexed \u0394RV end\u2010systolic volume (11 versus 20\u00a0mL\/BSA\n              <jats:sup>1.3<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.034). The change in the RV ejection fraction during the interstage period between the 2 groups did not meet statistical significance (\u22122 versus \u22125,\n              <jats:italic>P<\/jats:italic>\n              =0.056); however, the trend continued to be favorable for the digoxin group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Digoxin use during the interstage period is associated with better preservation of the RV volume and tricuspid valve measurements leading to less adverse remodeling of the single ventricle. These findings suggest a possible mechanism of action explaining digoxin\u2019s survival benefit during the interstage period.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021443","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T12:33:34Z","timestamp":1638448414000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Association of Digoxin With Preserved Echocardiographic Indices in the Interstage Period: A Possible Mechanism to Explain Improved Survival?"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9862-4297","authenticated-orcid":false,"given":"Maria","family":"Batsis","sequence":"first","affiliation":[{"name":"Sibley Heart Center Cardiology Children\u2019s Healthcare of Atlanta Atlanta GA"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Kochilas","sequence":"additional","affiliation":[{"name":"Sibley Heart Center Cardiology Children\u2019s Healthcare of Atlanta Atlanta GA"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0417-8653","authenticated-orcid":false,"given":"Alvin J.","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Perelman School of Medicine University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-6350","authenticated-orcid":false,"given":"Michael","family":"Kelleman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Sibley Heart Center Cardiology Children\u2019s Healthcare of Atlanta Atlanta GA"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2243-8367","authenticated-orcid":false,"given":"Matthew E.","family":"Oster","sequence":"additional","affiliation":[{"name":"Sibley Heart Center Cardiology Children\u2019s Healthcare of Atlanta Atlanta GA"},{"name":"Department of Pediatrics Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029375"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02795-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02720-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912461"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.04.028"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-0974-7"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002566"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002376"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036821"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01131-0"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.08.033"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12834"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.117.006983"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.01.013"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2012.02.008"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.072694"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12760"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.9.1265"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.80.1.65"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-018-0292-1"}],"container-title":["Journal of the American Heart 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